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Dieting for Diabetes: a Mobile 'App'roach Alaina Brooks Darby University of Mississippi

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Dieting for Diabetes: a Mobile 'App'roach Alaina Brooks Darby University of Mississippi University of Mississippi eGrove Honors College (Sally McDonnell Barksdale Honors Theses Honors College) 2014 Dieting for Diabetes: A Mobile 'App'roach Alaina Brooks Darby University of Mississippi. Sally McDonnell Barksdale Honors College Follow this and additional works at: https://egrove.olemiss.edu/hon_thesis Part of the Pharmacy and Pharmaceutical Sciences Commons Recommended Citation Darby, Alaina Brooks, "Dieting for Diabetes: A Mobile 'App'roach" (2014). Honors Theses. 15. https://egrove.olemiss.edu/hon_thesis/15 This Undergraduate Thesis is brought to you for free and open access by the Honors College (Sally McDonnell Barksdale Honors College) at eGrove. It has been accepted for inclusion in Honors Theses by an authorized administrator of eGrove. For more information, please contact [email protected]. Dieting for Diabetes: A Mobile ‘App’roach by Alaina Brooks Darby A thesis submitted to the faculty of The University of Mississippi in partial fulfillment of the requirements of the Sally McDonnell Barksdale Honors College. Oxford May 2014 Approved by __________________________ Advisor: Dr. Matthew Strum __________________________ Reader: Dr. Michael Warren __________________________ Reader: Dr. Erin Holmes © 2014 Alaina Brooks Darby ALL RIGHTS RESERVED ii Abstract Diabetes mellitus, being a prevalent disease in modern society, is moderately influenced by one’s nutrition. Due to this, mobile programs created especially for tracking food intake can be an important aid for diabetics. The objective of this project was to analyze eight of the most prominent of these applications – MyNetDiary, GoMeals, MyFitnessPal, Fooducate, Lose It!, The Carrot, Diabetes In Check, and Daily Carb – to determine the subsets of diabetics that would benefit most from the utilization of each. Data was obtained through testing of each app and through the information provided by users on iTunes and Google Play and on the website of the company producing the app, if applicable. From these sources, the usability and features of the app were determined. To determine the usability of each app, both personal testing and user reviews were considered. Using the most basic version of each app, the efficiency and effectiveness were established through experimentation and trial entries. User satisfaction was ascertained by examining the ratings and reviews of each app as found on the iTunes App Store website. The features were deduced through a combination of all methods of data collection and analyzed based upon their usefulness to certain diabetics. Finally, recommendations were made for those who would be able to maximize the benefits of each app based on diabetes type, recency of diagnosis, severity of condition, eating habits, special dietary considerations, age, location, and other more specific factors. iii Findings show that specific apps appear to be more relevant to the generalized diabetic population but that even greater specificity of the apps is also pertinent for certain categories within the diabetic populace. Each of the eight apps could be recommended for certain groupings of diabetic individuals by being more relevant to their specific needs. Ultimately, the combination of personal characteristics for a user determines which app he should select in order to most effectively manage his diabetes. iv Table of Contents List of Tables vi List of Abbreviations vii Diabetes and Its Types 1 Diabetes Maintenance and Treatment 4 Nutritional Tracking 10 Evaluation Criteria of TLC Apps 12 Analysis and Recommendations for MyNetDiary® 15 Analysis and Recommendations for GoMeals® 20 Analysis and Recommendations for MyFitnessPal® 25 Analysis and Recommendations for Fooducate™ 31 Analysis and Recommendations for Lose It!® 36 Analysis and Recommendations for TheCarrot.com® 40 Analysis and Recommendations for Diabetes In Check® 46 Analysis and Recommendations for Daily Carb® 50 Summary of Apps 54 List of References 58 Appendix 69 v List of Tables Table 1: Types of Oral Medications and Their Functions 6 Table 2: Evaluation of Apps Based Upon Usability 70 Table 3: Evaluation of Apps Based Upon Cost and Platforms 71 Table 4: Evaluation of Apps Based Upon Food Database, Logging 72 Options, and Location Table 5: Evaluation of Apps Based Upon Additional Tracking Options 73 Table 6: Evaluation of Apps Based Upon Personalization 74 Table 7: Evaluation of Apps Based Upon Progress and Social Aspects 75 Table 8: Evaluation of Apps Based Upon Available API 76 vi List of Abbreviations A1C Hemoglobin A1C AADE American Association for Diabetes Educators ADA American Diabetes Association API application programming interface app mobile application BP blood pressure carbs carbohydrates DM Diabetes Mellitus DRS Diabetes Risk Score GI glycemic index GMO genetically modified organism HDL high-density lipoprotein IDDM insulin-dependent diabetes mellitus LDL low-density lipoprotein RBC red blood cell SMBG self monitoring of blood glucose T1DM Type 1 Diabetes Mellitus T2DM Type 2 Diabetes Mellitus TLC therapeutic lifestyle change vii Diabetes and Its Types Diabetes mellitus (DM), more commonly referred to as diabetes, is a prevalent disease in the United States that affects nearly 10% of individuals (National Diabetes Fact Sheet 1). Diabetes, however, is actually a more generalized term that denotes a grouping of similar metabolic diseases, all pertaining to the body’s inability to either efficiently produce or utilize insulin or a combination of the two (“Diagnosis and Classification of Diabetes Mellitus” 564). Insulin, a hormone that is produced by the β-cells of the pancreas, is instrumental in lowering the concentration of glucose, or sugar, in the blood (König and Holzhütter 1). This is done by either the body’s immediate utilization of blood glucose following a meal or by promoting its storage in bodily tissues (“Insulin Basics”). Either the insufficient synthesis or the inadequate action of insulin, individually or in combination with one another, leads to a problematically high concentration of glucose in the bloodstream, a condition known as hyperglycemia (“Diagnosis and Classification of Diabetes Mellitus” 564). Due to the prospect of a hyperglycemic condition and its hazardous effects, tests are available to measure blood glucose and, therefore, aid in diagnosis. An individual may have laboratory tests performed to measure aspects of blood glucose in addition to the self-monitoring of blood glucose (SMBG). SMBG measures the concentration of blood glucose at a specific moment utilizing a personal blood glucose meter. (Diabetes A to Z: what you need to know about diabetes, simply put 2). Another laboratory parameter commonly used for diagnosing or evaluating diabetes control is the Hemoglobin A1C (A1C). An A1C 1 value reflects the percent of glucose attached to hemoglobin within the red blood cells (RBC). When a RBC is formed, hemoglobin, an oxygen-carrying protein found in the blood, becomes bound with glucose. With increased concentrations of blood glucose, more glucose is available for binding. Formation of glucose- bound hemoglobin is, therefore, increased, allowing the measurement of glycosylated hemoglobin in the RBC to indicate the concentrations of blood glucose over a period of time. The lifespan of a RBC is approximately four months and the hemoglobin and glucose remain joined until the cell’s death. Due to this, the A1C test is able to indicate average blood glucose for a period of 2-3 months. It is this more comprehensive average that allows the A1C test to be useful for diagnosing and evaluating diabetes. (Diabetes A to Z : what you need to know about diabetes, simply put 1). Though blood glucose concentrations, as influenced by insulin, may be the pivotal factor in each form of diabetes, the causes and manifestations of the specific forms of the disease differ greatly. Some types of the disease are induced by drugs or other chemicals, genetic defects, pancreatic diseases, infections, immune system disorders, and even pregnancy. Though other forms exist, Type 1 Diabetes Mellitus (T1DM) and Type 2 Diabetes Mellitus (T2DM) are the most predominant, accounting for more than 95% of diabetes cases. As an indication of the prevalence of these two subsets of the disease, T1DM and T2DM are often referred to by their more generic nicknames of juvenile-onset and adult-onset, respectively (“Diagnosis and Classification of Diabetes Mellitus” 564-565). These terms describe the usual timeline of the manifestation of each 2 type, an attribute that is dependent upon the underlying cause for the disease’s appearance. T1DM constitutes 5 - 10% of diagnosed diabetes cases in adults and generally arises during childhood but may present itself, though rarely, in adulthood (“Diagnosis and Classification of Diabetes Mellitus” 565). Since individuals with T1DM suffer from the inability to produce insulin, either in sufficient quantities or in total, this type of diabetes was formerly known as insulin-dependent diabetes mellitus (IDDM) due to the resulting reliance on administered insulin to regulate blood glucose (National Diabetes Fact Sheet 11). The loss of insulin production, though occasionally without an identifiable cause, is generally the result of an autoimmune response in which the insulin-producing β-cells of the pancreas are attacked and destroyed (“Standards of Medical Care in Diabetes – 2013” S11, “Diagnosis and Classification of Diabetes Mellitus” 564- 565). Because the body cannot produce the insulin necessary to maintain blood glucose homeostasis, hyperglycemia
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